4 Steps to Being Worry Free

Take control of your anxiety by following this expert advice

By
Gail Saltz, MD

Dec 29, 2010

Sam Edwards/Getty Images

Even though she said her life was pretty good, Carol,* 48, came to see me because she couldn't stop worrying about what would happen if her husband lost his job or if her son's struggles in school would mean that he'd never get into college. "A lot of the time, I have this feeling that something terrible is about to happen, and really, I don't even know what it is," she told me. I call this a case of the "what-ifs." "What if I'm late to work and I miss my meeting?" Or worse: "What if this stomachache is actually an ulcer?" "What if my child is late coming home from school because she's been kidnapped?" The truth is, everyone worries. And some worrying actually helps you cope and function. Being stressed out about a big meeting, for example, can help motivate you to prepare for it. But too much worrying creates tension and anxiety, which zaps concentration, making you unable to cope.

If you find yourself worrying a lot, ask yourself some preliminary questions that I always ask my patients: Do you worry more than half the day, every day? Do these thoughts break in during otherwise pleasant times, like when you're watching a movie, reading a book or talking with your family, and make it hard to concentrate in general? Do you feel jittery and nervous? A little short of breath? Like you want to pace or even jump out of your skin sometimes? Do you avoid activities that you'd normally like to do because you feel too worried? Essentially, is anxiety keeping you from being you?

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If you answered yes to one or more of these questions, and you've been feeling this way for a few weeks, then worrying is taking up too much space in your mind. And it can start to have an effect on your mental and physical well-being. Worrying creates stress—and feeling this way in the long term raises your risk of so many health problems, including heart disease, ulcers, irritable bowel syndrome and even asthma. Not to mention that the anxiety can interfere with your ability to concentrate and sleep, and make you generally irritable. At the heart of it, constant worry keeps you from fully participating in the joys of everyday life.

Like just about all health conditions, worry tends to run in families. So if one of your close relatives (a parent, grandparent or sibling) tends to be a worrier, then chances are you're prone to it as well. Also, anxiety is twice as common in women as it is in men, which isn't surprising when you consider that women tend to be more aware of their emotions and manage the emotional well-being of other people in their lives. Excessive worrying can lead to Generalized Anxiety Disorder (GAD), a common emotional issue that affects about 6.8 million Americans each year, 60 percent of them women. But GAD is very treatable (more on that later), and just because you worry doesn't mean you have GAD.

The following steps can go a long way toward easing your mind.

1. Recognize You're Worrying.

Carry a pen and paper with you and jot down a worry when it comes into your head. Recording your thoughts is called self-observation, and it can help diminish the intensity of your anxiety and its effect on you. Sounds so basic, but by writing down what's worrying you, you're better able to understand it, which helps it feel more contained and manageable. For example, Lynn, a 39-year-old banker, came to see me because she had been having trouble sleeping for several weeks. It wasn't until she wrote down her worries that she realized her concerns about her mother's declining health and her son not making the basketball team were giving her insomnia.

Noting your worries also helps you realize how often (or not) you're really doing it. People often say "I worry all the time," but when they go through the day and note when they worry, they may realize that they're only doing it once or twice. And that gives them some reassurance that things aren't as bad as they thought. Record your worries for at least a day or two. Often, my patients keep doing it until they've worked through the stressful period because it makes them feel better. Photo: Thinkstock

2. Do a Reality Check.

Once you have your anxieties in writing, ask yourself, "What are the chances that this worry will actually happen? Can I do something about this, and if so, have I done all that I can do?" This can help you see that the worries may be exaggerated, that you're overworrying and/or that you have things more under control than you thought.

When Lynn explored her fear that her son wouldn't make the basketball team, she realized that this was connected to a deeper anxiety that if he didn't make the team, he would feel like a failure and that she, in turn, would feel like she'd failed him as a mother. Thinking through the worry helped her see that if the worst happened and her son didn't make the team, it would be an opportunity for him to gain the valuable life skill of learning how to deal with disappointment. And that in fact it's her job as a (good) mother to teach him how to cope. Photo: Thinkstock

3. Make a Plan.

This helps break the worry cycle: The more you worry, the more out of control you feel, which makes you worry even more. Putting action steps in writing can give you a handle on the situation. List your specific worries, then write down two or three concrete things you can do about each one. If you're stressing about something that could happen (but hasn't yet), write down what you would do if it did. Once Carol had listed her concerns about her son and husband, she decided to deal with her son's difficulties in school by having him tested to understand his exact issues and how to best help him. Outlining this plan eased her anxiety.

Carol's worries about her husband's job stability stemmed from the fact that he had been passed over for a promotion, and she feared that he would become depressed or anxious. She made a plan to talk to her husband about how he was handling the loss. Their discussions helped her see that he wasn't falling apart. In fact, her support made him feel better, and she felt more relaxed knowing that she was helping the situation. Photo: Shutterstock

4. Relax Your Body and Mind.

As I mentioned before, emotions can manifest themselves physically: Being anxious can cause aches, pains and muscle tension—and vice versa. So relaxing your body can help relax your mind. Most people are unaware of how tense their muscles really are and how shallow their breathing is.

When you're in a state of worry, sit down in a comfortable spot, close your eyes and take 5 minutes to breathe in from your belly, inhaling through your nose for a slow count to five, then exhaling through your mouth for a slow count to five. Release the tension in your body by contracting, then slowly releasing, each and every muscle, starting with your feet and moving up to the legs, buttocks, arms, hands, fingers, neck and face. (This can take 5 to 10 minutes.) Keep taking slow, deep breaths, in through your nose and out through your mouth.

Visual imagery can also help. Imagine the most peaceful scene you can and try to see it, hear it, smell it. Maybe it's being in your backyard on a spring day or at the beach listening to the waves as they hit the shoreline. Mentally go to your "happy place" while you breathe in and out for a slow count of four. Carol found that using visual imagery to relax for 10 minutes every day— particularly before she spoke to her husband about his situation—helped many of her worries to lessen. Photo: Thinkstock

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When to Get Help If worrying is stressing you out, consider seeing a mental health professional. Talking through your concerns with a therapist can often put them in perspective and help you feel better. In particular, cognitive behavioral therapy, in which the therapist teaches you how to change anxious thought patterns, can help in as little as 10 sessions. Check out the Anxiety Disorders Association of America (ADAA.org) to find a therapist near you. Severe worry (also known as Generalized Anxiety Disorder or GAD) involves having uncontrollable anxiety most days and physical symptoms including restlessness, fatigue, difficulty concentrating, irritability, muscle tension and trouble sleeping for at least 6 months. It is highly treatable with therapy and medication if necessary.

Gail Saltz, MD, a psychiatrist and psychoanalyst, is a clinical associate professor of psychiatry at the New York Presbyterian Hospital, a TODAY show contributor and author of Becoming Real and Anatomy of a Secret Life.

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